OverviewThe NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer: Noninvasive and Special Situations presented here are the work of the NCCN Breast Cancer panel members. Categories of evidence and consensus were assessed and are noted in the algorithms and text. Although not explicitly stated at every decision point of the guidelines, patient participation in prospective clinical trials is the preferred option of treatment for all stages of breast cancer. These NCCN Guidelines focus on noninvasive breast cancer and special situations, such as Paget's disease, phyllodes tumor, breast cancer during pregnancy, and axillary breast cancer. Another NCCN guideline addresses invasive breast cancer (see NCCN Clinical Practice Guidelines in Oncology [NCCN Guidelines] for Breast Cancer: Invasive and Inflammatory; to view the complete and most recent version of these guidelines, visit the NCCN Web site at www.NCCN.org).The American Cancer Society estimates that 194,280 new cases of invasive breast cancer were diagnosed and 40,610 died of the disease in the United States in 2009.1 In addition, approximately 62,280 women were diagnosed with carcinoma in situ of the breast during the same year. Breast cancer is the most common malignancy in women in the United States and is second only to lung cancer as a cause of cancer death.The incidence of breast cancer has increased steadily in the United States over the past few decades, but breast cancer mortality seems to be declining,1,2 suggesting a benefit from early detection and more effective treatment.The origin of most breast cancer...

Early Breast Cancer Trialists' Collaborative Group. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet2005;365:1687–1717.

Early Breast Cancer Trialists' Collaborative Group. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet2005;365:1687–1717.
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BijkerN, MeijnenP, PeterseJL. Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: ten-year results of European Organisation for Research and Treatment of Cancer randomized phase III trial 10853—a study by the EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group. J Clin Oncol2006;24:3381–3387.

BijkerNMeijnenPPeterseJL. Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: ten-year results of European Organisation for Research and Treatment of Cancer randomized phase III trial 10853—a study by the EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group. J Clin Oncol2006;24:3381–3387.
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EmdinSO, GranstrandB, RingbergA. SweCDIS: radiotherapy after sector resection for ductal carcinoma in situ of the breast. Results of a randomized trial in a population offered mammography screening. Acta Oncol2006;45:536–543.

EmdinSOGranstrandBRingbergA. SweCDIS: radiotherapy after sector resection for ductal carcinoma in situ of the breast. Results of a randomized trial in a population offered mammography screening. Acta Oncol2006;45:536–543.
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HoughtonJ, GeorgeWD, CuzickJ. Radiotherapy and tamoxifen in women with completely excised ductal carcinoma in situ of the breast in the UK, Austraila, and New Zealand: randomised controlled trial. Lancet2003;362:95–102.

HoughtonJGeorgeWDCuzickJ. Radiotherapy and tamoxifen in women with completely excised ductal carcinoma in situ of the breast in the UK, Austraila, and New Zealand: randomised controlled trial. Lancet2003;362:95–102.
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BijkerN, RutgersEJ, DuchateauL. Breast-conserving therapy for Paget disease of the nipple: a prospective European Organization for Research and Treatment of Cancer study of 61 patients. Cancer2001;91:472–477.

BijkerNRutgersEJDuchateauL. Breast-conserving therapy for Paget disease of the nipple: a prospective European Organization for Research and Treatment of Cancer study of 61 patients. Cancer2001;91:472–477.
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JohnsonPH, GwynK, GordonN. The treatment of pregnant women with breast cancer and the outcomes of the children exposed to chemotherapy in utero [abstract]. J Clin Oncol2005;23(Suppl 1):Abstract 540.

JohnsonPHGwynKGordonN. The treatment of pregnant women with breast cancer and the outcomes of the children exposed to chemotherapy in utero [abstract]. J Clin Oncol2005;23(Suppl 1):Abstract 540.
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